Diabetes has been a cause of concern in the Indian subcontinent for a while now. And if popular research studies and reports are to be trusted, then the condition is only expected to worsen in the coming years. 

So, what is the current state of affairs?

On World Diabetes Day 2019, the International Diabetes Foundation, Diabetes Atlas estimated the number of diabetics in India to be around 77 million. The only country that’s surpassing India in these numbers is China with a whopping 116 million diabetics. 

Dr. A. Ramachandran, a member of the Diabetes Atlas Committee, stated- “Diabetes, being a lifestyle disorder with multidimensional causative factors, definitely needs a multidimensional approach. Once diabetes is diagnosed, currently, there is only fragmented care especially because our health delivery system is modeled for acute care rather than for chronic care. In the future, the costs will soar, and we will not be able to afford them.” 

So, where is the ray of hope?

In terms of blood sugar concerns, the primary ray of hope is in making basic lifestyle changes to ensure you do not worsen the condition. And the first step toward transitioning to a healthy lifestyle is quitting sugar. 

Does That Mean No More Sweetness?

Well, no!

It just means staying away from sugar or sweeteners that have an impact on your blood glucose level or that contribute to insulin resistance. 

But, are there safe sweetening agents for diabetics? 

Certainly! There are many healthy sugar substitutes for diabetics that help ease their lifestyle transition by balancing both cravings and health. 

Let’s begin by understanding the type of sweeteners that exist in the current market and which one can you trust if you suffer from diabetes. 

What are the Types of Sweeteners?

The types of sweeteners are essentially divided into two categories - artificial sweeteners and natural sweeteners. Let’s see what these terms mean. 

Artificial Sweeteners

Artificial sweeteners are synthetic sugar substitutes that are commonly found in most products that claim to be sugar-free. Some common artificial sweeteners are Aspartame, Sucralose, Dextrose, etc. 

These sweeteners are generally considered safe when consumed in moderation. 

But, what do the research studies say?

Various research studies have found that excess consumption of artificial sweeteners can have several short to long-term effects. A study published in the National Library of Medicine associated excess consumption of Aspartame, an artificial sweetener, with an increased risk of type 2 diabetes, cardiovascular concerns, and hormonal cancers.

Another study published in the Journal of Toxicology and Environmental Health found that sucralose reduces the number of good bacteria in your intestines by 50 percent. This means an overly compromised gut health, a home to autoimmune conditions, digestive issues like bloating, diarrhea, poor sleep, skin rashes and breakouts, and tiredness all the time. Additionally, rather than being an aid for diabetics, sucralose causes a spike in your glucose levels and so a spike in insulin. So, when the insulin level rises, it puts the brakes on burning fat and encourages the storage of incoming food, mostly as fat. Sucralose has the same impact on the body as sugar despite being a low-calorie sweetener. 

Natural Sweeteners

Natural Sweeteners are alternatives to sugar that are derived from natural and often safe sources. These include stevia, monk fruit, jaggery, honey, etc. 

However, natural sweeteners can be further divided into two categories. 

• Sweeteners with High Glycemic Index

These are sugar alternatives that do have a natural origin but also have a considerable GI value, which can also be greater than sugar at times. For instance, jaggery has a GI value of 84, which is more than that of table sugar (65). So, jaggery will have the same or even worse impact on blood sugar levels. 

• Sweeteners with Zero Glycemic Index

Zero GI natural sweeteners often have zero calories, zero carbs, and zero glycemic index value. This means that they can be easily incorporated into a diabetes-friendly lifestyle as they do not adversely impact blood sugar levels. Some examples are Stevia and Monk Fruit. 

What are the Best Sugar Substitutes for Diabetics? 

Now that you have a deeper understanding of the kinds of sugar substitutes, let’s find out the three best sugar replacement options that can be safely used if you have diabetes. 

1. Stevia

Stevia Rebaudiana, or what is commonly known as stevia, is a plant of the chrysanthemum family. The whole plant is not used for making stevia sweeteners. Instead, a highly refined and sweet stevia leaf extract, known as rebaudioside A (Reb-A), is used for making stevia sugar. 

• Glycemic Index: 0 
• Calorie Content: 0
• Carb Content: 0
• Sweetness Profile:

Rebaudioside A (Reb-A), the extract of stevia leaves, is 200 times sweetener than table sugar. However, stevia extract does tag along with a bitter aftertaste, which does not agree with everyone. 

• Health Benefits: 

1. For Diabetics: Another benefit of using stevia is that it has zero glycemic index value, which means people suffering from diabetes can readily use it without experiencing a sudden blood sugar spike. 
2. For Weight Watchers: As a non-nutritive, it has zero calories, which may be a great attraction for weight watchers. 

• Is Stevia Safe?

FDA recognizes stevia as generally safe for consumption. The fact that it does not get metabolized and is simply excreted by the body makes it an ideal choice for diabetes patients as it will produce no blood sugar spikes or crashes. 

• How to Use:

1. Stevia can be a great substitute for sugar in tea and coffee.
2. You can also use this sugar alternative while baking cakes, muffins, etc. 
3. As stevia does not caramelize, it may not be the best substitute for sugar in recipes where the sweetener’s role is to add texture or structure to the dish. 

2. Monkfruit 

Monk Fruit has become the talk of the town in recent times. Monk fruit, or lo han guo, is named after the monks who first cultivated it. It’s primarily found in China and looks like a small green melon. The reason why monk fruit has taken the wellness industry by storm is because of its many health benefits that have been explored in Traditional Chinese Medicine (TCM) for decades now. 

• Glycemic Index: 0
• Calorie Content: 0
• Carb Content: 0
• Sweetness Profile:

Monk fruit sweetener is derived from dried monk fruit extract which is 150-250 times sweeter than sugar. 

• Health Benefits:

1. For Diabetics: Monk fruit gets its sweetness from a compound known as mogrosides. With a zero calorie, zero carbs, and zero GI profile, it does not lead to a sudden blood sugar spike. 
2. For Weight Watchers: Since monk fruit sugar does not tag along empty calories, it will facilitate the state of calorie deficit that promotes weight loss. 

• Is Monk Fruit Safe?

Since monk fruit is new to the market, there have been various speculations about its safety. However, the Food and Drug Administration (FDA) deems monk fruit safe for consumption by everyone, including children and pregnant women. 

• How to Use: 

1. Monk fruit sweetener can be used to potentially sweeten anything including tea, coffee, sauces, smoothies, etc. 
2. As monk fruit is heat stable, it can also be used while preparing baked goods. 

3. Erythritol

Erythritol is mainly derived after a type of yeast ferments wheat or corn starch. However, erythritol is also naturally found in some substances. 

It’s essentially a type of carbohydrate that’s classified as sugar alcohol. 

• Glycemic Index: 0
• Calorie Content: 0.2 calorie/gram
• Carb Content: 4g Carbs/teaspoon (4g)
• Sweetness Profile: Erythritol sweetener is 60-80% as sweet as table sugar. 
• Health Benefits:

1. For Diabetics: Erythritol sweetener does get absorbed in the bloodstream but is excreted unchanged in the urine. Studies have shown that this sweetener prevents blood sugar spikes and is diabetes-friendly.

1. For Weight Watchers: Being a non-nutritive sweetener, erythritol barely carries any calories that can derail weight watchers from their diet. 

• Is Erythritol Safe?

Going by FDA norms, Erythritol is labeled as safe. Even multiple studies performed on both animals and humans have given a clean chit to this sugar replacement option. However, when consumed in excess, it may cause mild side effects in form of digestive concerns. 

The best way to use erythritol is to use it in combination with other natural sweeteners such as stevia or monk fruit. 

• How to Use:

1. Erythritol can be exactly used like sugar in most food and beverages. For instance, you can add it to your tea, coffee, juices, etc. 
2. In the case of baked goods, it will add sweetness, but may not be a value addition in terms of texture or structure. 

Takeaway

Diabetes management is beyond just taking medication. It’s also about making small yet relevant lifestyle changes, including replacing sugar with a natural sugar substitute for diabetics. Stevia, Monk Fruit, and Erythritol are sugar alternatives that can ease your transition to a healthier lifestyle. And if you find a sweetener that’s a proportionate blend of these three, then there is nothing more you can ask for.